Study on clinical efficacy of integrated traditional Chinese and western medicine in the treatment of pulmonary tuberculosis

doi:10.19982/j.issn.1000-6621.20220131

Abstract

Abstract:

Objective:To evaluate the clinical efficacy of conventional chemotherapy combined with traditional Chinese medicine (TCM) anti-tuberculosis mixture and appropriate traditional Chinese medicine technology in the treatment of pulmonary tuberculosis (PTB). Methods:Using the approach of a prospective study, 300 primary diagnosed and treated TB patients in the Tuberculosis Department of Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine were continuously collected from January 2017 to December 2019. According to the random number table, patients were equally divided into 3 groups, the conventional western medicine anti-TB treatment group (group A), conventional western medicine anti-TB treatment combined with TCM anti-TB mixture group (group B), and conventional western medicine anti-TB treatment combined with TCM anti-TB mixture and TCM appropriate technology group (Group C). After excluding 24 patients due to diagnosis changes, treatment interruption and adverse reactions, 276 patients were finally included in group A (n=97), group B (n=93) and group C (n=86). The improvement of TCM symptoms, absorption of pulmonary lesions, changes of T lymphocyte subsets and treatment outcomes were observed and compared among the three groups. Results:After 6 months of treatment, in group B and group C, the effective rate of TCM syndromes improvement (92.5% (86/93) and 94.2% (81/86)), the effective rate of pulmonary lesions absorption (92.5% (86/93) and 94.2% (81/86)), the percentage of CD3⁺T cells ((65.76±5.42) % and (67.06±5.95) %), the percentage of CD4⁺T cells ((44.97±5.35) % and (46.51±5.26) %), and the effective rate of treatment (94.6% (88/93) and 97.7% (84/86)) were significantly better than those in group A (82.5% (80/97), 76.3% (74/97), (63.80±4.57) %, (42.72±4.82) %, 80.4% (78/97)), the differences were statistically significant (χ²=2.000, P=0.046; χ²=2.999, P=0.003; χ²=2.427, P=0.015; χ²=2.886, P=0.004; t=2.699, P=0.008; t=4.186, P=0.005; t=3.048,P=0.003; t=6.428, P<0.001; χ²=2.069, P=0.039; χ²=2.192, P=0.028, respectively). The percentages of CD8⁺T cells in group B and C ((27.12±2.32) % and (26.35±3.17) %) were significantly lower than that in group A ((29.12±2.21) %), and the difference was statistically significant (t=5.051, P<0.001; t=9.231, P<0.001, respectively). Conclusion:The traditional Chinese and western medicine combined with anti-TB regimen can significantly reduce the clinical symptoms of PTB patients, promote the absorption of pulmonary lesions, improve the immunity of PTB patients, and effectively improve the clinical efficacy, however, the application effect of TCM appropriate technology has not been confirmed.

Key words: Tuberculosis,pulmonary, Drugs, Chinese herbal, Therapeutic uses, Treatment outcome

CLC Number:

He Meiyan, Zhang Zunjing, Liu Zhongda. Study on clinical efficacy of integrated traditional Chinese and western medicine in the treatment of pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2022, 44(10): 1037-1042. doi: 10.19982/j.issn.1000-6621.20220131

Figures/Tables 4

组别	CD3⁺(%, $x ¯$ ±s)		CD4⁺(%, $x ¯$ ±s)		CD8⁺(%, $x ¯$ ±s)
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组(97例)	61.43±5.99	63.80±4.57	38.32±5.23	42.72±4.82	31.21±2.38	29.12±2.21
B组(93例)	62.16±5.86	65.76±5.42	37.02±5.13	44.97±5.35	30.07±3.15	27.12±2.32
C组(86例)	62.27±5.27	67.06±5.95	38.51±5.34	46.51±5.26	31.62±2.23	26.35±3.17
F值	2.668	19.636	3.612	20.588	2.651	18.276
P值	0.071	<0.001	0.891	<0.001	0.689	<0.001
t_AB值	-	2.699		3.048		5.051
P_AB值		0.008		0.003		<0.001
t_AC值		4.186		6.428		9.213
P_AC值		0.005		<0.001		<0.001
t_BC值		1.530		1.940		1.864
P_BC值		0.128		0.054		0.064

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组别	治愈 [例(构成比,%)]	显效 [例(构成比,%)]	有效 [例(构成比,%)]	无效 [例(构成比,%)]	合计 [例(改善率,%)]
A组(97例)	62(63.9)	10(10.3)	8(8.3)	17(17.5)	80(82.5)
B组(93例)	70(75.3)	10(10.8)	6(6.4)	7(7.5)	86(92.5)
C组(86例)	71(82.6)	6(7.0)	4(4.6)	5(5.8)	81(94.2)

组别	显著吸收 [例(构成比,%)]	吸收 [例(构成比,%)]	无改变 [例(构成比,%)]	失败 [例(构成比,%)]	合计 [例(有效率,%)]
A组(97例)	31(32.0)	43(44.3)	19(19.6)	4(4.1)	74(76.3)
B组(93例)	39(41.9)	47(50.5)	6(6.5)	1(1.1)	86(92.5)
C组(86例)	39(45.3)	42(48.8)	4(4.7)	1(1.2)	81(94.2)

组别	治愈 [例(构成比,%)]	完成疗程 [例(构成比,%)]	治疗未成功 [例(构成比,%)]	治疗成功 [例(成功率,%)]
A组(97例)	43(44.3)	35(36.1)	19(19.6)	78(80.4)
B组(93例)	50(53.7)	38(40.9)	5(5.4)	88(94.6)
C组(86例)	46(53.5)	38(44.2)	2(2.3)	84(97.7)